PDF(Pubmed)
Abstract：
A 42-year-old hunter with no previous medical history suffered an accidental gunshot injury while hunting. Upon arrival at our Hospital, the following musculosceletal laesions were diagnosed during the primary survey: comminuted right trochanteric and femur neck fracture, femoral and sciatic nerve palsy. The immediate damage control surgery consisted of debridement, jet-lavage, PMMA-chain insertion and extrafocal fixation. Structural neural damage was disclosed. Primarily the skin wound was treated by delayed closure and later the healing was supported by Negative Pressure Wound Therapy. Six weeks after, the extrafocal fixation was removed and antibiotic spacer was inserted. Primary wound healing occurred without any sign of infection. Neurological recovery of the extremity took almost a year. Low grade infection were excluded by serial labs and culture samples. Finally the patient underwent total hip arthroplasty with excellent result.
摘要：
一名42岁的猎人在狩猎时遭受了意外的枪伤。到达我们医院后，在初步调查中诊断出以下肌层粘连：粉碎性右转子和股骨颈骨折，股骨和坐骨神经麻痹。即时损伤控制手术包括清创术，喷射灌洗,PMMA链插入和外固定。披露了结构性神经损伤。主要通过延迟闭合来治疗皮肤伤口,并且随后通过负压伤口治疗来支持愈合。六周后,取出外焦外固定物并插入抗生素垫片.最初的伤口愈合没有任何感染迹象。四肢的神经系统恢复花了将近一年的时间。系列实验室和培养样品排除了低度感染。最后，患者接受了全髋关节置换术，效果良好。
